LIC62 Physical Examination Form

Use a LIC62 Physical Examination Form 2017 template to make your document workflow more streamlined.

What the LIC62 form does

The LIC62 Physical Examination Form records the information needed to document a physical examination, including patient details, clinical findings, examination dates, and required healthcare signatures. It is completed by the patient and examining clinician or other authorized parties according to the organization or authority requesting it. With signNow, a team can upload the LIC62 PDF, review automatically detected fillable fields, assign each field to the right participant, send the form electronically, and retain the completed document with an audit trail. HIPAA workflows require a business associate agreement and appropriate organizational controls.

Who benefits from LIC62 workflows

LIC62 is most useful when a healthcare team must collect examination information and signatures consistently across patients, clinicians, locations, or review stages.

Solo medical practices can use a reusable LIC62 template to collect patient details, examination findings, and clinician signatures without rebuilding the document for each appointment.
Occupational health clinics can route LIC62 forms between employees, examining clinicians, and administrative reviewers while keeping completed examination records organized and access-controlled.
Enterprise healthcare systems can standardize LIC62 completion across locations with shared templates, delegated sending, role permissions, audit trails, and HIPAA workflows requiring a BAA.

Reusable template

A reusable LIC62 template keeps patient identifiers, examination fields, provider attestations, and signature areas in consistent positions, reducing manual reformatting when clinics process repeated physical examination submissions.

Fillable fields

Auto-detected fillable fields help convert the LIC62 document into an electronic workflow, allowing staff to identify where patient information, clinical findings, dates, and signatures belong before sending it.

Role-based routing

Role-based routing separates the patient, examining clinician, and reviewer responsibilities, making it clearer who must complete each LIC62 section and reducing misplaced or missing attestations.

Audit trail

A signNow audit trail records signing activity, timestamps, and document history, giving healthcare administrators a structured record to review when questions arise about the completed LIC62 form.

Mobile access

Mobile signing lets clinicians and patients review LIC62 on supported devices, which can reduce delays when examination details or signatures must be completed away from a workstation.

HIPAA controls

HIPAA-compliant signNow workflows, with a BAA required, provide controls for handling protected health information while the LIC62 document moves between authorized participants.

Steps to complete LIC62 online

Use a controlled sequence to prepare the LIC62 form, route each section to the right participant, and preserve the completed record.

Upload form:
Upload the LIC62 PDF to signNow.
Map fields:
Review auto-detected fields and add missing fields.
Assign roles:
Assign patient and clinician recipients.
Send request:
Send LIC62 for review and signatures.
Archive record:
Store the completed form with audit evidence.

Setting	Recommendation
Authentication method	Email link with SMS verification
Signature type	Typed or drawn electronic signature
Audit trail	Export with certificate of completion
Document retention	Six years for HIPAA records
Encryption	TLS 1.2 or 1.3 and AES-256

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Best practices for LIC62 completion

Complete LIC62 with verified clinical information, controlled access, correctly assigned signatures, and a preserved signNow audit record.

Verify clinical details before sending

Review every patient and provider field before sending. Confirm dates, measurements, medical history responses, and required signatures are complete. Use signNow’s field validation to prevent blank required fields, then compare the completed document against the clinician’s source records before finalizing the LIC62 form.

Protect patient information throughout completion

Keep the patient’s identifying information limited to the LIC62 workflow. Use signNow role permissions to restrict access, require authentication for sensitive recipients, and avoid forwarding completed forms through unencrypted email. Confirm each recipient’s identity before releasing examination information.

Assign each signature field carefully

Send the form to the correct signer in sequence. Assign patient, examining clinician, and authorized reviewer fields separately so each person signs only their designated section. signNow templates and reusable roles help prevent signatures from being placed in the wrong location.

Preserve the signed record and audit trail

Download the completed LIC62 form together with its certificate of completion and audit trail. Store both records in an access-controlled system with a documented retention policy, because the signed form alone may not establish who signed, when, or how the record was handled.

Privacy pitfalls in LIC62 workflows

Including a patient’s full medical history in an LIC62 email attachment can expose protected health information to unintended recipients or unapproved mail systems.
Failing to capture electronic consent before sending LIC62 information may weaken evidence that the patient agreed to receive and sign records digitally.
Leaving completed LIC62 documents available to every workspace user can expose examination findings beyond the treating or reviewing team’s authorized access.
Using a shared signing link without identity verification can make it difficult to attribute the LIC62 signature to the intended patient or clinician.

Find and fill out the correct lic62 physical examination form

airSlate SignNow helps you fill in and sign documents in minutes, error-free. Choose the correct version of the editable PDF form from the list and get started filling it out.

Versions	Form popularity	Fillable & printable
NY LIC62 2017	4.8 Satisfied (4607 Votes)
NY LIC62 2017	4.7 Satisfied (329 Votes)

Platform requirements for LIC62

Complete LIC62 through signNow using Chrome, Firefox, Safari, or Edge on Windows 10, macOS, iOS, or Android. SignNow protects data in transit with TLS 1.2 or 1.3, and its mobile apps support document review and signing when clinicians or patients are away from a desktop.

Supported browsers Chrome, Firefox, Safari, Edge
Operating systems Windows 10, macOS, iOS, Android
Secure connection TLS 1.2 or 1.3 connection

Healthcare organizations should manage devices that access LIC62 records, apply role-based permissions, and confirm that mobile access follows internal privacy policies. Teams using APIs, SSO, or certificate-based controls should verify the selected signNow plan and configure identity, retention, and audit requirements before production use.

Integrations for LIC62 records

Connect LIC62 workflows with healthcare operations through Salesforce, Microsoft 365, Google Drive, Box, Egnyte, NetSuite, and signNow’s API-enabled integration options.

Security controls for LIC62 data

Data in transit:

TLS 1.2 and TLS 1.3

Stored data:

AES-256 encryption at rest

Healthcare compliance:

HIPAA with BAA required

Operational controls:

SOC 2 Type II certified

Security management:

ISO 27001 certified

Privacy frameworks:

GDPR and CCPA compliant

Authenticate signer:

Authenticate the intended patient or clinician before opening the LIC62 signing session.

Record timestamp:

Capture the signing event time alongside the LIC62 workflow activity.

Log actions:

Record document changes and signing actions in the audit history.

Seal record:

Preserve the completed LIC62 document with its signing evidence.

Complete certificate:

Generate the certificate of completion after required signatures are finished.

Export evidence:

Retrieve and export the audit trail for controlled archival.

LIC62 document retention schedule

Retention depends on the record’s purpose, not only its LIC62 label. Apply the rule governing the underlying healthcare, employment, tax, injury, or exposure record.

Six years for HIPAA records

HIPAA requires documentation retention for six years from creation or the last effective date under 45 CFR §164.530(j).

Three years for tax records

Federal tax records generally require three years from filing under IRC §6501(a), when the LIC62 record is part of a tax-supporting file.

Three years after hire or termination

Employment records require three years after hire or one year after termination, whichever is later, under 8 CFR §274a.2(b)(2)(i)(A).

Five years for OSHA injury records

OSHA injury records require five years following the reporting year under 29 CFR §1904.33, if LIC62 supports an injury record.

Thirty years for exposure records

OSHA exposure records require thirty years under 29 CFR §1910.1020, if examination information forms part of exposure documentation.

Risks of incomplete LIC62 records

Incomplete examination record

Missing clinician attestation

Unattributed consent

Unassigned patient signature

Privacy exposure

Unprotected health information

Weak signature proof

Missing audit evidence

LIC62 troubleshooting and questions

Resolve LIC62 completion issues by checking field mapping, signer routing, healthcare safeguards, audit evidence, and the legal conditions for electronic signatures.

If signNow does not detect LIC62 fields correctly, upload the clearest PDF version and review every detected field manually. Add missing text, date, checkbox, and signature fields before sending; automatic detection does not replace clinical or administrative verification.

Business includes legally binding eSignatures, templates, audit trails, and mobile apps at $8 per user per month with annual billing. Business Premium costs $15 per user per month annually and adds bulk send, which may help larger LIC62 batches.

signNow lists HIPAA compliance with a business associate agreement required. Confirm that the account, recipients, storage process, and organization’s privacy program satisfy healthcare obligations; a platform setting alone does not determine whether the complete LIC62 workflow is compliant.

If a signer cannot open the LIC62 request, verify the email address, resend the invitation, and check whether organizational filtering blocks signNow messages. A shareable signing link or SMS authentication may provide an alternative when enabled for the selected workflow.

For a missing completion record, open the completed document in signNow and retrieve its certificate of completion and audit trail. The audit record should be stored with the LIC62 PDF so the organization can connect the signature event to the final document.

Electronic signatures generally receive legal recognition under ESIGN and applicable state electronic-transaction law when intent, consent, attribution, and record retention are demonstrated. Consumer-facing workflows may also require the ESIGN disclosure and access requirements in 15 U.S.C. §7001(c).

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